Decision Support Interventions (DESI) for Prostate Cancer Screening - Study 1

We will use a randomized experimental design to compare the effects of 3 different
strategies to implement a prostate cancer screening decision support intervention (DESI)
with a control condition in primary care in 2 clinical systems - PAMF (Palo Alto Medical
Foundation) and UNC. The primary outcomes of interest are men's screening decisions and
their subsequent healthcare utilization. Secondary outcomes include the likelihood that
they review the DESI and their decision-specific knowledge. The 3 strategies selected by the
PAMF and UNC health systems are: (1) mailing men a DESI in DVD; (2) inviting men to
participate in a shared (group) medical appointment (SMA) to watch and discuss the DESI with
a healthcare provider and other men; and (3) providing men options by inviting them to a SMA
while also providing them a DESI in DVD which they can use individually if they are unable
or choose not to attend a SMA. The 3 groups will be compared to a control condition that
does not receive a DESI but will be encouraged to discuss prostate cancer screening with
their physician. Because of its significantly larger patient population, the PAMF site will
also evaluate these outcomes by targeting screening-naïve patients on their 50th birthday,
when they first become guideline eligible to consider prostate cancer screening.